[Voiding syndrome of gynaecological origin: the importance of good physical examination].

OBJECTIVES

Urologists daily evaluate many women with voiding disturbances, but proper physical examination has only rarely been previously performed.

CASE DESCRIPTION: Case 1: 16-year-old woman presenting augmented daytime urinary frequency and nocturia without enuresis, with drop-by-drop micturition. Case 2: 80-year-old woman with urgency. She referred normal voiding with insensitive urinary loss the hour after.

PHYSICAL EXAMINATION: adhesion of the labia minora.

TREATMENT: Surgical section of the adhered area in the midline was performed with satisfactory aesthetic and clinical results.

CONCLUSIONS

The adhesion of the labia minora is an acquired disease, more frequent in girls under 2 years. Several predisposing factors have been proposed: oestrogen deprivation, inadequate personal care, local irritants, infections or previous trauma. Differential diagnosis is required among three congenital pathologies: vaginal agenesis, imperforated hymen and ambiguous genitalia. Cases in postpubertal or postmenopausal women, or refractory to medical treatment are considered for surgery.